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Prospective Study for Symptomatic Relief of ET With Cala Therapy (PROSPECT)

Primary Purpose

Essential Tremor

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Cala TWO
Sponsored by
Cala Health, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Essential Tremor

Eligibility Criteria

22 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Must be ≥22 years of age
  • Competent and willing to provide written, informed consent to participate in the study
  • A diagnosis of essential tremor as confirmed from clinical history and examination by a movement disorder neurologist
  • A tremor severity score of 2 or above in the dominant hand/arm as measured by any one of the TETRAS upper limb items and a minimum subset score of 6 across all upper limb items
  • Significant disability due to essential tremor (Bain & Findley score of 3 or above in any one of the upper limb items and a minimum subset score of 8 across all upper limb items)
  • Stable dose of tremor medications, if applicable, for 30 days prior to study entry
  • Stable dose of antidepressant medications, if applicable, for 90 days prior to study entry
  • Willing to comply with study protocol requirements including:

    • remaining on a stable dosage of tremor and antidepressant medications, if applicable, during the duration of the study
    • no significant alcohol or caffeine consumption within 8 hours prior to study visits
    • no usage of the Cala TWO device within 8 hours prior to study visits

Exclusion Criteria:

  • Moderate to severe ethanol dependence as defined by the criteria outlined in the DSM-5 (score of 4 or higher)
  • Implanted electrical medical device, such as a pacemaker, defibrillator, or deep brain stimulator, or implanted metal in the wrist to be stimulated
  • Previous thalamotomy procedure, including stereotactic thalamotomy, gamma knife radiosurgical thalamotomy, and focused ultrasound for the treatment of tremor
  • Suspected or diagnosed epilepsy or other seizure disorder
  • Swollen, infected, inflamed areas, or skin eruptions, open wounds, or cancerous lesions of skin at stimulation site
  • Peripheral neuropathy affecting the tested upper extremity
  • Presence of any other neurodegenerative disease like Parkinson-plus syndromes suspected on neurological examination. These include: multisystem atrophy, progressive supranuclear palsy, dementia with Lewy bodies, and Alzheimer's disease.
  • Anyone suspected to have the diagnosis of idiopathic Parkinson's disease (PD). This includes excluding anyone with the presence of parkinsonian features including bradykinesia rigidity, or postural instability. Subjects who exhibit only mild resting tremor but no other symptoms or signs of PD may be included.
  • Botulinum toxin injection for hand tremor within 6 months prior to study enrollment
  • Are participating or have participated in another interventional clinical trial in the last 30 days which may confound the results of this study, unless approved by the Sponsor
  • Significant alcohol or caffeine consumption within 8 hours prior to study enrollment, which may confound the results of the study, where significant caffeine is considered more than 95 mg (equivalent to a cup of coffee), and significant alcohol is considered more than 14 g (equivalent to 5 oz of wine, 12 oz of beer, or 1.5 oz of distilled spirits).
  • Subjects unable to communicate with the investigator and staff
  • Any health condition that in the investigator's opinion should preclude participation in this study
  • Pregnancy or anticipated pregnancy during the course of the study

Sites / Locations

  • Barrow Neurological Institute (Dignity Health)
  • USC
  • Parkinson's Institute and Clinical Center
  • University of California San Francisco
  • Pacific Neuroscience Institute
  • Rocky Mountain Movement Disorders Center
  • Hospital for Special Care
  • Medstar Gerogetown Health Institute
  • Parkinson's Center
  • USF
  • Augusta University
  • Rush University Medical Center
  • Kansas University Medical Center
  • Kaiser Mid-Atlantic Group
  • Deaconess Medical Center
  • Henry Ford Health System
  • Mayo Clinic
  • Advanced Neurology Specialists
  • Parkinson's Disease and Movement Disorders Center of Long Island
  • Mount Sinai & Beth Isreal
  • Duke University
  • Wake Forest
  • River Hills Neuroscience
  • Cleveland Clinic
  • University Of Pennsylvania Medicine
  • Jefferson University
  • University of Texas Southwestern
  • Texas Movement Disorder Specialist
  • Houston Methodist
  • Central Texas Neurology Consultants
  • Swedish
  • EvergreenHealth Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Cala TWO

Arm Description

Two 40-minute stimulation sessions daily, separated by at least two hours

Outcomes

Primary Outcome Measures

TRG (Tremor Research Group) Essential Tremor Rating Assessment Scale (TETRAS) Subset Score
Tremor Research Group (TRG) Essential Tremor Rating Assessment Scale (TETRAS) subset score: TETRAS subset score relevant to the stimulated upper limb. The subset score is the sum of 6 rated tasks. Each task is rated 0 to 4, where a higher score indicates more severe tremor. Minimum subset score = 0; Maximum subset score = 24.
Bain & Findley Activities of Daily Living (ADL) Scale Subset Score
Bain & Findley ADL subset score relevant to the stimulated upper limb. The subset score is the sum of 8 rated tasks. Each task is rated 1 to 4, where a higher score indicates more severe tremor. Minimum subset score = 8; Maximum subset score = 32.

Secondary Outcome Measures

Kinematic Measurements, as Collected With the Device During Postural Holds, Change From Pre-stimulation to Post-stimulation Across Sessions
Subjects will be prompted to perform a postural hold task before and after each stimulation session. During this task, the device will record kinematic data using on-board motion sensors to objectively assess if there are any changes in tremor level. The change in each patient's pre- and post-stimulation tremor power was defined as the median change over all valid stimulation sessions. Sample mean and standard deviations were computed using the median change value from all patients.

Full Information

First Posted
June 27, 2018
Last Updated
October 10, 2023
Sponsor
Cala Health, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03597100
Brief Title
Prospective Study for Symptomatic Relief of ET With Cala Therapy
Acronym
PROSPECT
Official Title
Prospective Study for Symptomatic Relief of Essential Tremor With Cala Therapy
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Completed
Study Start Date
December 14, 2018 (Actual)
Primary Completion Date
May 29, 2019 (Actual)
Study Completion Date
May 29, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cala Health, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Prospective, multi-center, single-arm, non-significant risk study designed to evaluate the Cala TWO device. Subjects will be screened for eligibility and fitted with a Cala TWO device. Subjects will wear the device at home for a period of 3 months, during which they will be asked to stimulate their dominant hand twice a day. The stimulation amplitude will be based on each subject's stimulation threshold. Subjects will have in clinic assessments at enrollment, month 1 and 3.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Essential Tremor

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
263 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cala TWO
Arm Type
Experimental
Arm Description
Two 40-minute stimulation sessions daily, separated by at least two hours
Intervention Type
Device
Intervention Name(s)
Cala TWO
Intervention Description
Wrist-worn stimulator which applies a tremor-customized stimulation pattern to an individual's nerves
Primary Outcome Measure Information:
Title
TRG (Tremor Research Group) Essential Tremor Rating Assessment Scale (TETRAS) Subset Score
Description
Tremor Research Group (TRG) Essential Tremor Rating Assessment Scale (TETRAS) subset score: TETRAS subset score relevant to the stimulated upper limb. The subset score is the sum of 6 rated tasks. Each task is rated 0 to 4, where a higher score indicates more severe tremor. Minimum subset score = 0; Maximum subset score = 24.
Time Frame
Baseline to 3-months
Title
Bain & Findley Activities of Daily Living (ADL) Scale Subset Score
Description
Bain & Findley ADL subset score relevant to the stimulated upper limb. The subset score is the sum of 8 rated tasks. Each task is rated 1 to 4, where a higher score indicates more severe tremor. Minimum subset score = 8; Maximum subset score = 32.
Time Frame
Baseline to 3-months
Secondary Outcome Measure Information:
Title
Kinematic Measurements, as Collected With the Device During Postural Holds, Change From Pre-stimulation to Post-stimulation Across Sessions
Description
Subjects will be prompted to perform a postural hold task before and after each stimulation session. During this task, the device will record kinematic data using on-board motion sensors to objectively assess if there are any changes in tremor level. The change in each patient's pre- and post-stimulation tremor power was defined as the median change over all valid stimulation sessions. Sample mean and standard deviations were computed using the median change value from all patients.
Time Frame
Average change in tremor power over 3-month study period

10. Eligibility

Sex
All
Minimum Age & Unit of Time
22 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Must be ≥22 years of age Competent and willing to provide written, informed consent to participate in the study A diagnosis of essential tremor as confirmed from clinical history and examination by a movement disorder neurologist A tremor severity score of 2 or above in the dominant hand/arm as measured by any one of the TETRAS upper limb items and a minimum subset score of 6 across all upper limb items Significant disability due to essential tremor (Bain & Findley score of 3 or above in any one of the upper limb items and a minimum subset score of 8 across all upper limb items) Stable dose of tremor medications, if applicable, for 30 days prior to study entry Stable dose of antidepressant medications, if applicable, for 90 days prior to study entry Willing to comply with study protocol requirements including: remaining on a stable dosage of tremor and antidepressant medications, if applicable, during the duration of the study no significant alcohol or caffeine consumption within 8 hours prior to study visits no usage of the Cala TWO device within 8 hours prior to study visits Exclusion Criteria: Moderate to severe ethanol dependence as defined by the criteria outlined in the DSM-5 (score of 4 or higher) Implanted electrical medical device, such as a pacemaker, defibrillator, or deep brain stimulator, or implanted metal in the wrist to be stimulated Previous thalamotomy procedure, including stereotactic thalamotomy, gamma knife radiosurgical thalamotomy, and focused ultrasound for the treatment of tremor Suspected or diagnosed epilepsy or other seizure disorder Swollen, infected, inflamed areas, or skin eruptions, open wounds, or cancerous lesions of skin at stimulation site Peripheral neuropathy affecting the tested upper extremity Presence of any other neurodegenerative disease like Parkinson-plus syndromes suspected on neurological examination. These include: multisystem atrophy, progressive supranuclear palsy, dementia with Lewy bodies, and Alzheimer's disease. Anyone suspected to have the diagnosis of idiopathic Parkinson's disease (PD). This includes excluding anyone with the presence of parkinsonian features including bradykinesia rigidity, or postural instability. Subjects who exhibit only mild resting tremor but no other symptoms or signs of PD may be included. Botulinum toxin injection for hand tremor within 6 months prior to study enrollment Are participating or have participated in another interventional clinical trial in the last 30 days which may confound the results of this study, unless approved by the Sponsor Significant alcohol or caffeine consumption within 8 hours prior to study enrollment, which may confound the results of the study, where significant caffeine is considered more than 95 mg (equivalent to a cup of coffee), and significant alcohol is considered more than 14 g (equivalent to 5 oz of wine, 12 oz of beer, or 1.5 oz of distilled spirits). Subjects unable to communicate with the investigator and staff Any health condition that in the investigator's opinion should preclude participation in this study Pregnancy or anticipated pregnancy during the course of the study
Facility Information:
Facility Name
Barrow Neurological Institute (Dignity Health)
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85013
Country
United States
Facility Name
USC
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Facility Name
Parkinson's Institute and Clinical Center
City
Mountain View
State/Province
California
ZIP/Postal Code
94040
Country
United States
Facility Name
University of California San Francisco
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Facility Name
Pacific Neuroscience Institute
City
Santa Monica
State/Province
California
ZIP/Postal Code
90404
Country
United States
Facility Name
Rocky Mountain Movement Disorders Center
City
Denver
State/Province
Colorado
ZIP/Postal Code
80113
Country
United States
Facility Name
Hospital for Special Care
City
New Britain
State/Province
Connecticut
ZIP/Postal Code
06053
Country
United States
Facility Name
Medstar Gerogetown Health Institute
City
Georgetown
State/Province
District of Columbia
ZIP/Postal Code
20007
Country
United States
Facility Name
Parkinson's Center
City
Boca Raton
State/Province
Florida
ZIP/Postal Code
33486
Country
United States
Facility Name
USF
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
Facility Name
Augusta University
City
Augusta
State/Province
Georgia
ZIP/Postal Code
30912
Country
United States
Facility Name
Rush University Medical Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
Kansas University Medical Center
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States
Facility Name
Kaiser Mid-Atlantic Group
City
Largo
State/Province
Maryland
ZIP/Postal Code
20774
Country
United States
Facility Name
Deaconess Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Henry Ford Health System
City
West Bloomfield
State/Province
Michigan
ZIP/Postal Code
48322
Country
United States
Facility Name
Mayo Clinic
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55902
Country
United States
Facility Name
Advanced Neurology Specialists
City
Great Falls
State/Province
Montana
ZIP/Postal Code
95405
Country
United States
Facility Name
Parkinson's Disease and Movement Disorders Center of Long Island
City
Long Island City
State/Province
New York
ZIP/Postal Code
10017
Country
United States
Facility Name
Mount Sinai & Beth Isreal
City
New York
State/Province
New York
ZIP/Postal Code
10003
Country
United States
Facility Name
Duke University
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Name
Wake Forest
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Facility Name
River Hills Neuroscience
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45255
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
University Of Pennsylvania Medicine
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Jefferson University
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19144
Country
United States
Facility Name
University of Texas Southwestern
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States
Facility Name
Texas Movement Disorder Specialist
City
Georgetown
State/Province
Texas
ZIP/Postal Code
78628
Country
United States
Facility Name
Houston Methodist
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Central Texas Neurology Consultants
City
Round Rock
State/Province
Texas
ZIP/Postal Code
78681
Country
United States
Facility Name
Swedish
City
Bellevue
State/Province
Washington
ZIP/Postal Code
98004
Country
United States
Facility Name
EvergreenHealth Medical Center
City
Kirkland
State/Province
Washington
ZIP/Postal Code
98034
Country
United States

12. IPD Sharing Statement

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Prospective Study for Symptomatic Relief of ET With Cala Therapy

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